genel tıp derg

Genel Tıp Dergisi

2602-3741

Selçuk Üniversitesi

10.54005/geneltip.1750288

Clinical Sciences (Other)

Klinik Tıp Bilimleri (Diğer)

Dimetil Fumarat Tedavisi Alan Multiple Skleroz Hastalarında İki Yıllık Eritrosit Dağılım Genişliği – Standart Sapma Değişimi: Retrospektif Bir Analiz

Two-year Red Cell Distribution Width–Standard Deviation Change in Multiple Sclerosis Patients Receiving Dimethyl Fumarate Treatment: A Retrospective Analysis

https://orcid.org/0000-0003-2552-5527

Sahin

Oruc

AKSARAY ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0002-9325-1292

Güneş

Muzaffer

AKSARAY ÜNİVERSİTESİ, TIP FAKÜLTESİ

04 22 2026

36 2026 1 6 07 24 2025 12 11 2025

1990

Genel Tıp Dergisi

Amaç: Bu çalışmada, dimetil fumarat (DMF) tedavisi alan relapsing-remitting multipl skleroz (RRMS) hastalarında eritrosit dağılım genişliği – standart sapma (RDW-SD) dahil hematolojik ve inflamatuar parametrelerdeki iki yıllık değişimlerin, hastalık progresyonu ve tedavi yanıtıyla ilişkisi değerlendirildi.Gereç ve Yöntemler: Retrospektif olarak tasarlanan çalışmaya, kesintisiz DMF tedavisi alan 58 RRMS hastası dahil edilmiştir. Hastaların iki yıl öncesine ait ve güncel hematolojik verileri karşılaştırılmış; white blood cell (WBC), lenfosit, monosit, red cell distribution width – standard deviation (RDW-SD) gibi parametrelerin yanı sıra nötrofil/lenfosit (NLR), monosit/lenfosit (MLR) ve trombosit/lenfosit (PLR) gibi inflamatuar indeksler analiz edilmiştir. Normal dağılıma uygunluk Kolmogorov-Smirnov testi ile değerlendirilmiş; uygun testlere göre Paired t-test, Wilcoxon ve Spearman korelasyon analizleri uygulanmıştır.Bulgular: DMF tedavisi sonrası RDW-SD (p<0,001), NLR (p=0,005), MLR (p=0,003) ve PLR (p=0,001) değerlerinde anlamlı artış gözlenmiştir. Lenfosit düzeyleri anlamlı şekilde azalmıştır (p=0,002). Expanded Disability Status Scale (EDSS) ile monosit değişimi (r=0,386; p=0,003) ve trombosit/monosit (PMR) farkı (r=–0,297; p=0,023) arasında istatistiksel olarak anlamlı korelasyonlar saptanmıştır. RDW-SD’deki artışın klasik RDW- coefficient of variation (CV)’den bağımsız olması dikkat çekicidir (p=0,57).Sonuçlar: DMF tedavisi süresince RDW-SD düzeylerinde gözlenen artış, bu parametrenin inflamatuar aktiviteyle ilişkili olabileceğini düşündürmektedir. RDW-SD, kişiselleştirilmiş tedavi yaklaşımlarında yardımcı bir biyobelirteç olarak değerlendirilebilir. Ancak bu bulguların doğruluğunu teyit etmek için daha ileri araştırmalara ihtiyaç vardır.

Aim: This study evaluated the relationship between two‑year changes in hematological and inflammatory parameters—including red cell distribution width–standard deviation (RDW‑SD)—and disease progression and treatment response in relapsing‑remitting multiple sclerosis (RRMS) patients receiving dimethyl fumarate (DMF).Materials and Methods: This retrospective study included 58 RRMS patients receiving uninterrupted DMF treatment. Hematological data from two years prior and current values were compared. Parameters analyzed included white blood cell count (WBC), lymphocytes, monocytes, RDW‑SD, and inflammatory indices such as neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR). Normality was assessed by the Kolmogorov–Smirnov test, and paired t‑test, Wilcoxon signed-rank test , and Spearman correlation analyses were applied as appropriate.Results: Significant increases in RDW-SD (p<0.001), NLR (p=0.005), MLR (p=0.003), and PLR (p=0.001) were observed after DMF treatment. Lymphocyte counts decreased significantly (p=0.002). Statistically significant correlations were observed between the change in monocyte count and the Expanded Disability Status Scale (EDSS) score (r=0.386; p=0.003), and between the change in platelet‑to‑monocyte ratio (PMR) and EDSS (r=–0.297; p=0.023). Notably, the increase in RDW‑SD was independent of the conventional RDW-coefficient of variation (CV) (p=0.57).Conclusions: The increase in RDW-SD levels observed during DMF treatment suggests that this parameter may be associated with inflammatory activity. RDW-SD could be evaluated as an auxiliary biomarker in personalized treatment approaches. However, further research is needed to confirm these findings.

Dimethyl fumarate Multiple sclerosis Red cell distribution width Inflammation mediators Immunomodulation

Dimetil Fumarat Multipl Skleroz Eritrosit Dağılım Genişliği İnflamatuvar Belirteçler İmmünmodülasyon

None

Not Applicable

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